Various types of implantable penile prostheses are available for treatment of erectile dysfunction, and various specialized tools exist for implanting such prostheses. A typical penile prosthesis includes at least one pair of cylinders that are inflatable and are each implantable in one of the corpus cavernosa. The penile prosthesis further includes a pump external to the cylinder for pressurizing the cylinder. The pump is typically connected to the cylinder through a tubing near the proximal end of the cylinder. Each cylinder has a fluid tube connected thereto between the ends at a position spaced further from the distal end and closer to the proximal end thereof. A pump is disposed in the scrotum, and connected through tubing to a spherical abdominal reservoir. The reservoir is placed in the pelvic area near the urinary bladder behind the muscles of the abdominal wall. The cylinders are inflated as fluid is pumped from the reservoir, and are deflated as fluid is transferred back to the reservoir. This inflation and deflation allows the patient to control whether his penis is erect or flaccid. An example of such penile prosthesis is the AMS 700™ inflatable penile prosthesis manufactured by American Medical Systems, Inc. Further illustrative of the devices available is that disclosed in U.S. Pat. No. 4,590,927 that relates to a unitary penile prosthesis which comprises a tubular enclosure having a distal portion which includes a pump, a medial portion including a pressurizable chamber which contains an internal tubular, substantially non-distensible portion and a concentric tubular sleeve, and a proximal portion defining a fluid reservoir therewithin.
Both U.S. Pat. No. 4,350,151 and U.S. Pat. No. 4,244,370 disclose tools, respectively known as the Scott and Furlow et al. tools, which among other things are used to introduce a suture-carrying needle into the penile corporus cavernosa. Thus, example of surgical procedures employed in the art to implant penile prostheses provide that a tool known as the “Furlow Introducer” shoots a long straight needle (the “Keith Needle”) which holds a traction suture to a distal tip of the penile prosthesis cylinder. The Keith Needle is pushed with the Furlow Introducer through the glans penis in order to position the distal tip of the prosthesis underneath the proximal aspect of the glans penis. This approach is not entirely satisfactory because it does not permit placement of the prosthesis cylinder in the penis without puncturing of the glans penis and resulting in bleeding.
Similar and greater difficulties are encountered in the art with respect to positioning of the proximal tip of prosthesis cylinder in the penis. Difficulties are presented with respect to placement of the proximal tip without current instruments slipping off the cylinder, measurement of the placement of the proximal tip of the cylinder in the corpora of the penis, and reconciling this measurement with the total measurement of the penile length. It has also been difficult to achieve this placement without damaging the prosthesis
Instruments have been developed to assist in closing an incision made for the purpose of implanting the prosthesis. An example of such an instrument is disclosed in U.S. Pat. No. 5,484,450. The instrument comprises a very short arcuate spoon-like element welded on its convex side to a rigid, rod-shaped element. The distal end of the rod-shaped element has a V-shaped notch formed in the exterior thereof. The notch enables a suture needle to extend therethrough during a suturing operation to close the incision. The instrument has been found difficult to use since it is difficult to coordinate or align the V-shaped notch with the suture needle during the incision closing procedure.
Thus, there is a need in the art for an improved penile prosthesis that can be implanted without the use of needles, which can puncture the glans penis and the penile prosthesis, and instruments useful for implanting such improved penile prosthesis.
There is a further need for instruments useful in implanting the distal end of existing conventional penile prostheses without the use of needles and the possibility of puncturing the penile prosthesis and the glans penis. There also exists a need to provide an implant incision-closing instrument, which is more convenient to use and otherwise overcomes the disadvantages of the instruments of the prior art. There are no widely used tools specifically designed to assist in the implantation of the proximal cylinder end of penile prosthesis. Thus, there is a continuing need for penile implantation tools of this type that are safe, easy to use and versatile.
The invention disclosed herein is aimed at providing tools that achieve one or more of these goals while having substantially fewer drawbacks of the conventional tools. The invention is further aimed at providing an improved penile erection device and improved method for implanting such devices into the corpus cavernosum of the penis.